New Loan Information by jzu16173

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									Form 1951-4 Ultimate Recip ient Data Sheet
(Rev. 12-04)


                                           ULTIMATE RECIPIENT INFORMATION
 Ultimate Recipient
     Borrower Legal Name
          Organization type
    DUNS# (unless individual)
          Borrower Address
 Project Information
             Facility Address
                        County
                 NAICS Code
         NAICS Description
                  Jobs Saved
                Jobs Created
 Loan Information
               Loan Amount           $-
                 Closing Date        - (planned/actual)
            Term in months           - months
                Interest Rate        -%
     IR - fixed or variable?
                  IR Formula
         Payment structure
        Payment frequency
 UR Loan Sources
  Initial / Revolved funds?
                    $ from RD        $-
 $ from Intermed. Contrib            $-
 Collateral Information
 Real estate                         -
               Lien position?        -
 Equipment                           -
               Lien position?        -
 Other                               -
               Lien position?        -
 Personal Guaranties                 -
 Other Project Funds
 Bank Loans                          $-
                       Explain       -
 State/Local Funds                   $-
                       Explain       -
 Other Federal Funds                 $-
                       Explain       -
 Borrower Funds                      $-
                       Explain       -
 Other Funds                         $-
                       Explain       -
 Demographic Data
                           Race      -                                      Sex   -
  Ethnicity (Hispanic/NonHispanic)   -                                  Veteran   -

								
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